Epic ONE: Tools for Improving Care of LGBT Patients

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Epic ONE is coming! In honor of Pride Month, let’s explore how the electronic medical record can enhance the patient experience for LGBT patients, and help providers deliver the right care to all their patients.  

On November 7, Southern New Hampshire Health will go live with Epic and Elliot Health System will undergo a major upgrade. One of the key features providers across the SolutionHealth system will benefit from is the sexual orientation and gender identity (SOGI) Smartform for providers.

These optional questions guide us toward using the proper pronouns for each patient, which helps create a comforting environment. They also allow us to capture a more accurate look at the needs of our transgender and non-binary patients. From the SOGI questions, we can clearly know the organs that a patient has, which is vitally important when ordering screenings and immunizations. We can also document their use of hormones and affirming surgeries. Lastly, the SOGI questions make medicine safer for our LGBT patients as we can accurately capture not only their legal sex, but their sex assigned at birth. This is especially important when interpreting lab values and medication safety.

When a patient comes to the Elliot or Southern, here are a series of steps staff, nurses, and providers should take.

Check-In Staff:

  • Ask patient for preferred name if it’s not documented in Epic
  • Make any changes to the gender identity field and legal sex field if a patient self-discloses any of this information
  • Alert to person who will be assuming patient care of any changes to pronouns or a preferred name
  • Always use preferred name and pronouns when interacting with a patient

Medical Assistant or Nurse:

  • Confirm patients preferred name and date of birth
  • Alert provider of any preferred names or pronouns that the patient discloses
  • Update patient demographic fields for preferred name
  • If patient is getting lab work, confirm specimens have the patient’s legal name on them to ensure they are run properly by the lab
  • Always use preferred name and pronouns when interacting with a patient

Provider:

  • If patient is identified as a member of the LGBT community, confirm the patient’s demographics are accurate and open the SOGI Smartform
  • Ensure all other staff are aware of any preferred names and pronouns
  • Have discussions with patients about the need for legal name and legal sex on some paperwork such as consents for treatments
  • Always use preferred name and pronouns when interacting with a patient

Frequently Asked Questions About Epic’s SOGI Smartform

How can I find a patient’s preferred name or gender in Epic?

Preferred name will be the large name seen in the patient’s chart. Legal name will be in small font beneath a patient’s preferred name. Gender identity will also be present under the preferred name. If there is an “i” next to the gender identity in the chart, hover your cursor over the icon to view legal sex, sex assigned at birth, and gender identity. Preferred names will also appear on hospital wristbands.

What do I do if I am working with a patient who I believe may have a different gender identity other than what is listed in the chart?

A good place to start is by asking a patient’s preferred name and using it. Even non-transgender individuals have preferred names and will not be offended or confused by such question. If you are uncomfortable asking about preferred pronouns, you can always replace pronounces with the patient’s preferred name.

When performing sensitive exams, who should chaperone the encounter?

When working with transgender/gender non-binary patients, they should be given the option of either a male or female chaperone when feasible.

Will patients be able to update their SOGI demographics from My E-Chart?

Yes, patients will have the ability to edit preferred name, gender identity, and sexual orientation through My E-Chart.

For more answers to the questions you may have about Epic’s SOGI Smartform, stay tuned for more FAQs on SolutionHealth HQ!

To learn more about Epic ONE, click here.

For any questions or more information on LGBT patient care, please contact Eric Senneville, PA-C.